Role of Serum Pepsinogen Tests in Detection of Gastric Atrophy, Intestinal Metaplasia, Gastric Adenoma, and Gastric Cancer in South Korea
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Background/Aims: The aim of this study was to evaluate the efficacy of serum pepsinogen (sPG) tests for gastritis, gastric adenoma (GA), and gastric cancer (GC) using the enzyme‑linked immunosorbent assay-based GastroPanel kit and to investigate the correlation between Gastro- Panel- and Latex-enhanced Turbidimetric Immunoassay (L-TIA)-derived sPG results. Methods: sPG I and II levels and PG I/II ratios were measured using both kits in 2,204 participants, including 1,109 controls, 316 GA, and 779 GC patients. Results: The GastroPanel- and L-TIA-derived sPG results showed high concordance. An sPG I concentration of 70 ng/mL and a PG I/II ratio of 3 measured with the L-TIA kit corresponded to 100 ng/mL and 5.3 with the GastroPanel kit. sPG I decreased in the GA and GC groups, whereas sPG II was lower in the GA group, but higher in the GC group than that in control group. The PG I/II ratios significantly decreased in the GA and GC groups, especially for the intestinal type. The sensitivity and specificity of PG I/II ratio ≤5.3 using the GastroPanel kit for the detection of GA or GC were 51%–59% and 61%–66%, respectively, which were slightly higher than 51%–58% and 58%–63% using the L-TIA kit. The group with a PG I/II ratio ≤5.3 and Helicobacter pylori-negative status had the highest risk with an adjusted odds ratio of 3.36 for GA and 2.25 for GC, with more prominent increase in diffuse-type compared to intestinal-type. Conclusions: The GastroPanel kit showed non-inferiority compared to the L-TIA kit.
Abstract
Background/Aims: The aim of this study was to evaluate the efficacy of serum pepsinogen (sPG) tests for gastritis, gastric adenoma (GA), and gastric cancer (GC) using the enzyme‑linked immunosorbent assay-based GastroPanel kit and to investigate the correlation between Gastro- Panel- and Latex-enhanced Turbidimetric Immunoassay (L-TIA)-derived sPG results. Methods: sPG I and II levels and PG I/II ratios were measured using both kits in 2,204 participants, including 1,109 controls, 316 GA, and 779 GC patients. Results: The GastroPanel- and L-TIA-derived sPG results showed high concordance. An sPG I concentration of 70 ng/mL and a PG I/II ratio of 3 measured with the L-TIA kit corresponded to 100 ng/mL and 5.3 with the GastroPanel kit. sPG I decreased in the GA and GC groups, whereas sPG II was lower in the GA group, but higher in the GC group than that in control group. The PG I/II ratios significantly decreased in the GA and GC groups, especially for the intestinal type. The sensitivity and specificity of PG I/II ratio ≤5.3 using the GastroPanel kit for the detection of GA or GC were 51%–59% and 61%–66%, respectively, which were slightly higher than 51%–58% and 58%–63% using the L-TIA kit. The group with a PG I/II ratio ≤5.3 and Helicobacter pylori-negative status had the highest risk with an adjusted odds ratio of 3.36 for GA and 2.25 for GC, with more prominent increase in diffuse-type compared to intestinal-type. Conclusions: The GastroPanel kit showed non-inferiority compared to the L-TIA kit.